A Respirometric Technique to Evaluate Velopharyngeal Function in Speakers with Cleft Palate, with and without Prostheses

1987 ◽  
Vol 30 (2) ◽  
pp. 268-275 ◽  
Author(s):  
Harvey R. Gilbert ◽  
Carole T. Ferrand
Keyword(s):  
Cleft Palate ◽  
Nasal Airflow ◽  
Perceptual Judgments ◽  
Sentence Repetition ◽  
Air Volume ◽  
Syllable Repetition ◽  
Two Measures ◽  
Reported Data ◽  
Velopharyngeal Function ◽  
Repetition Task

There is a paucity of respirometric quotient (RQ) data on individuals with velopharyngeal inadequacy. Paesani (1964) reported data using a technique that involved separate productions of the same task to obtain the RQ. The RQ values obtained were greater than unity, which is theoretically impossible. In the present study, respirometric quotients, the ratio of oral air volume expended to total volume expended, were obtained using separate but simultaneous productions of oral and nasal airflow. RQ values were calculated for 10 speakers with cleft palate, with and without their prosthetic appliances, and 10 normal speakers. As a group, those with cleft palate and without their appliances exhibited RQ values that were significantly lower than values obtained from the normal speakers and from speakers with the appliances in place. These findings indicated that there were no statistically significant differences in RQ values when comparing sentence repetition and counting tasks. These values were lower than those obtained for the nonnasal syllable repetition tasks, with the/m/ syllable repetition task generally being associated with the lowest RQ value of any of the speech tasks. The correlation between RQ values and perceptual judgments was -.60, indicating that there was modest agreement between the two measures. As RQ values decreased, perceptual judgments of nasality increased.

Laryngeal Airway Resistance in Children with Cleft Palate and Adequate Velopharyngeal Function

1995 ◽  
Vol 32 (2) ◽  
pp. 138-144 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Cleft Palate ◽  
Airway Resistance ◽  
Vowel Production ◽  
Effort Level ◽  
Syllable Repetition ◽  
Velopharyngeal Closure ◽  
Velopharyngeal Function ◽  
Laryngeal Resistance ◽  
Repetition Task ◽  
Laryngeal Airway

Laryngeal airway resistance during vowel production was determined for 10 children without cleft palate and 14 children with cleft palate and adequate velopharyngeal function. The children with cleft palate were further grouped according to either complete or incomplete velopharyngeal closure. All children performed a syllable repetition task with nostrils occluded at self-determined effort and a targeted effort typical of adult speech. Results indicated that all children exhibited significantly greater laryngeal resistance at self-determined effort. No significant differences occurred among the groups of children at either effort level. Some children with incomplete velopharyngeal closure, however, tended to exhibit relatively increased laryngeal resistance at the targeted effort level when their nostrils were unoccluded. Implications for a regulation-control model of speech production and clinical assessment are discussed.

Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns

2002 ◽  
Vol 39 (4) ◽  
pp. 409-424 ◽  
Author(s):  
Hans Dotevall ◽  
Anette Lohmander-Agerskov ◽  
Hasse Ejnell ◽  
Björn Bake
Keyword(s):  
Cleft Palate ◽  
Sensitivity And Specificity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Strong Association ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Perceptual Evaluation ◽  
Velopharyngeal Function ◽  
The Relationship

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality.” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function.” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality.” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.

Aerodynamic and Temporal Aspects of Velopharyngeal Function in Normal Speakers

1996 ◽  
Vol 39 (6) ◽  
pp. 1199-1207 ◽  
Author(s):  
David J. Zajac ◽  
Robert Mayo
Keyword(s):  
Air Pressure ◽  
Nasal Airflow ◽  
Male And Female ◽  
Air Volume ◽  
Oral Pressure ◽  
Temporal Aspects ◽  
Volume Measurements ◽  
Intraoral Air Pressure ◽  
Entire Word ◽  
Velopharyngeal Function

Aerodynamic and temporal characteristics of velopharyngeal function were determined for 42 adult male and female speakers. All subjects produced the word "hamper" at self-determined loudness levels and rates of speaking. Measurements of intraoral air pressure, nasal airflow, and estimates of velopharyngeal orifice size were obtained during production of the /m/ and /p/ segments. Volume measurements of nasal airflow were determined for the entire word, the /m/ segment, and the segments preceding /m/. Fifteen timing measures associated with the pressure-flow events of the nasal-plosive sequence were also determined. Results indicated that males generated significantly higher levels of peak intraoral air pressure than females during /p/. Male speakers also exhibited a significantly shorter interval in the rise of oral pressure associated with the /p/ segment. Male and female speakers, however, exhibited similar levels of anticipatory coarticulation as reflected by nasal air volume measurements. Finally, variability of selected measurements within speakers suggested that temporal aspects of velopharyngeal function were more constrained than aerodynamic aspects. The results are discussed relative to (a) sex differences in respiratory and velar function and (b) normative data for adult speakers.

Perceptual Judgments of Resonance, Nasal Airflow, Understandability, and Acceptability in Speakers with Cleft Palate: Ordinal versus Visual Analogue Scaling

2017 ◽  
Vol 54 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Sarah Castick ◽  
Rachael-Anne Knight ◽  
Debbie Sell
Keyword(s):  
Cleft Palate ◽  
Nasal Airflow ◽  
Speech And Language ◽  
Rater Reliability ◽  
Street Hospital ◽  
Perceptual Judgments ◽  
Scaling Methods ◽  
Visual Analogue Scaling ◽  
Best Fit ◽  
Nasal Resonance

Objective To investigate the reliability of ordinal versus visual analogue scaling (VAS) ratings for perceptual judgments of nasal resonance, nasal airflow, understandability, and acceptability in speakers with cleft palate. Design Within-subjects comparative study. Setting Multisite. Participants Five specialist speech and language therapists from U.K. Regional Cleft Centres. Outcome Measures Participants rated 30 audio speech samples obtained from the Speech and Language Therapy archives of Great Ormond Street Hospital. They rated the identified speech parameters using each scaling method, with 1 month between rating tasks. The model of best fit was determined to examine validity, and both intra- and inter-rater reliability were also computed. Results VAS ratings were valid for all parameters when plotted against ordinal ratings, and the model of best fit revealed only a slightly stronger curvilinear than linear relationship between the scaling methods. Intra-rater reliability was high for both rating methods across all six speech parameters. There was also high inter-rater reliability for both ordinal and VAS ratings of hypernasality, nasal emission, nasal turbulence, understandability, and acceptability, and for the ordinal ratings of hyponasality. Conclusions Perceptual judgments of nasal resonance, nasal airflow, understandability, and acceptability were similar using VAS and ordinal scaling, indicating that both scaling methods were appropriate for measuring the cleft speech parameters. VAS, however, may offer statistical advantages, and there is a growing body of evidence advocating its use for the measurement of prothetic speech parameters.

scholarly journals Assessing understanding of relative clauses: a comparison of multiple-choice comprehension versus sentence repetition

2017 ◽  
Vol 44 (6) ◽  
pp. 1435-1457 ◽  
Author(s):  
PAULINE FRIZELLE ◽  
CLODAGH O'NEILL ◽  
DOROTHY V. M. BISHOP
Keyword(s):  
Relative Clauses ◽  
Sentence Comprehension ◽  
Multiple Choice ◽  
Typically Developing ◽  
Processing Load ◽  
Sentence Repetition ◽  
Additional Processing ◽  
Two Measures ◽  
Grammatical Structures ◽  
Repetition Task

AbstractAlthough sentence repetition is considered a reliable measure of children's grammatical knowledge, few studies have directly compared children's sentence repetition performance with their understanding of grammatical structures. The current study aimed to compare children's performance on these two assessment measures, using a multiple-choice picture-matching sentence comprehension task and a sentence repetition task. Thirty-three typically developing children completed both assessments, which included relative clauses representing a range of syntactic roles. Results revealed a similar order of difficulty of constructions on both measures but little agreement between them when evaluating individual differences. Interestingly, repetition was the easier of the two measures, with children showing the ability to repeat sentences they did not understand. This discrepancy is primarily attributed to the additional processing load resulting from the design of multiple-choice comprehension tasks, and highlights the fact that these assessments are invoking skills beyond those of linguistic competence.

Instrumental Assessment in Cleft Palate Care

2013 ◽  
Vol 23 (2) ◽  
pp. 49-61 ◽  
Author(s):  
Jamie Perry ◽  
Graham Schenck
Keyword(s):  
Cleft Palate ◽  
New Developments ◽  
Perceptual Evaluation ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Speech Language Pathologist ◽  
Hypernasal Speech ◽  
Perceptual Assessment ◽  
Velopharyngeal Function ◽  
And Function

Despite advances in surgical management, it is estimated that 20–30% of children with repaired cleft palate will continue to have hypernasal speech and require a second surgery to create normal velopharyngeal function (Bricknell, McFadden, & Curran, 2002; Härtel, Karsten, & Gundlach, 1994; McWilliams, 1990). A qualitative perceptual assessment by a speech-language pathologist is considered the most important step of the evaluation for children with resonance disorders (Peterson-Falzone, Hardin-Jones, & Karnell, 2010). Direct and indirect instrumental analyses should be used to confirm or validate the perceptual evaluation of an experienced speech-language pathologist (Paal, Reulbach, Strobel-Schwarthoff, Nkenke, & Schuster, 2005). The purpose of this article is to provide an overview of current instrumental assessment methods used in cleft palate care. Both direct and indirect instrumental procedures will be reviewed with descriptions of the advantages and disadvantages of each. Lastly, new developments for evaluating velopharyngeal structures and function will be provided.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

Effects of Sentence Structure on Sentence Elicited Imitation Responses

1978 ◽  
Vol 21 (4) ◽  
pp. 809-819 ◽  
Author(s):  
Jo Carol Hudgins ◽  
Walter L. Cullinan
Keyword(s):  
College Students ◽  
Sentence Processing ◽  
Relative Clause ◽  
Female College Students ◽  
Sentence Structure ◽  
Response Accuracy ◽  
Relative Pronoun ◽  
Elicited Imitation ◽  
Sentence Repetition ◽  
Repetition Task

This study investigates the effects of sentence structure on the number of error sentences and response latency in a sentence-repetition task. Forty female college students repeated short and long test sentences containing either a single self-embedded or right-branching subject-focus or object-focus relative clause. Sentences were also controlled for deletion of the relative pronoun of the relative clause. Sentence structure was found to affect sentence elicited imitation response accuracy and latency in a manner similar to the effects of structure on ease of comprehension. The findings are consistent with a canonical-sentoid strategy explanation of sentence processing during sentence imitation.

Cleft Palate in Kabuki Syndrome: A Report of Six Cases

2006 ◽  
Vol 43 (6) ◽  
pp. 756-761 ◽  
Author(s):  
Takuya Iida ◽  
Susam Park ◽  
Kogo Kato ◽  
Ichiko Kitano
Keyword(s):  
Cleft Palate ◽  
Clinical Features ◽  
Congenital Anomalies ◽  
Kabuki Syndrome ◽  
Characteristic Appearance ◽  
Submucous Cleft Palate ◽  
Velopharyngeal Function

Kabuki syndrome is a syndrome of rare congenital anomalies that was named after its characteristic appearance, a face resembling that of an actor in a Kabuki play. Although cleft palate is a feature that is sometimes observed in patients with Kabuki syndrome, there are few clinical reports of cleft palate associated with Kabuki syndrome. This report presents six cases of Kabuki syndrome with cleft palate and reviews their clinical features. Our results suggest that (1) patients with cleft palate in Kabuki syndrome tend to fail in acquiring normal velopharyngeal function and (2) submucous cleft palate might be more common in patients with Kabuki syndrome than previously was reported.

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